Clinical Advances in Periodontics最新文献

{"title":"Voclosporin-induced gingival enlargement: A case report.","authors":"Francesca Racca, Jessica M Greco, Dimitris N Tatakis","doi":"10.1002/cap.10369","DOIUrl":"https://doi.org/10.1002/cap.10369","url":null,"abstract":"<p><strong>Background: </strong>Drug-influenced gingival enlargement (DIGE) is a recognized adverse effect of certain medications, particularly immunosuppressants like cyclosporin and tacrolimus. However, there have been no documented cases of DIGE associated with voclosporin, a newer calcineurin inhibitor used primarily to treat lupus nephritis.</p><p><strong>Methods: </strong>This report describes the case of a 27-year-old female with systemic lupus erythematosus and lupus nephritis who developed significant gingival enlargement within 2 months of initiating voclosporin therapy. The patient presented with generalized gingival swelling, spontaneous bleeding, and difficulty eating, leading to her referral to a periodontics clinic. Nonsurgical periodontal therapy was initially attempted, followed by a biopsy to confirm the diagnosis.</p><p><strong>Results: </strong>Despite nonsurgical interventions, the gingival enlargement persisted. Surgical therapy was offered but declined by the patient. Following interdisciplinary consultation, the voclosporin dosage was gradually reduced, and the drug was eventually discontinued. Marked clinical improvement was observed within 1 month after drug discontinuation, with reduced enlargement and diminished pain.</p><p><strong>Conclusion: </strong>This case is the first to document gingival enlargement associated with voclosporin therapy. The findings emphasize the need for awareness of this potential adverse effect and highlight the importance of interdisciplinary care in managing such cases.</p><p><strong>Key points: </strong>Voclosporin may cause gingival enlargement, similar to other calcineurin inhibitors, such as cyclosporin. With voclosporin emerging as a promising alternative for nephrologists in managing lupus nephritis, its prescription rates are likely to rise, which accentuates the importance of dental professionals being informed and vigilant about associated adverse effects on gingival tissues. Discontinuation of voclosporin should be considered, in consultation with the patient's medical team, if its oral adverse effects outweigh its therapeutic benefits, underscoring the significance of interdisciplinary cooperation and care.</p><p><strong>Plain language summary: </strong>The gingiva (gums) is often a site in the mouth where changes or reactions can occur in response to certain systemic medications. Some drugs, particularly those used to treat autoimmune conditions or following organ transplants, can cause the gums to grow excessively, a condition known as drug-induced gingival enlargement (also known as gingival overgrowth). In this report, we document the case of a 27-year-old woman with lupus nephritis who developed gingival enlargement after starting a medication called voclosporin. This drug is a newer treatment option for lupus nephritis, but until now had not been linked to gingival enlargement. The patient experienced significant gum swelling, bleeding, and pain, making it difficult for her","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Papilla preservation technique for the reconstruction of the interdental papilla: A case report.","authors":"Luiz F de Castro, Ernani T de Souza, Maíza C A Ferreira, Camila S Senisse, Gabriella C Canhoni, Ana Júlia S de Andrade, Daniel J Braga Dutra","doi":"10.1002/cap.10349","DOIUrl":"https://doi.org/10.1002/cap.10349","url":null,"abstract":"<p><strong>Background: </strong>Interdental papilla reconstruction is frequently discussed in the literature, with techniques like tunnelization commonly used. However, tunnelization presents significant challenges in flap positioning, stabilization, and ensuring adequate blood supply to maintain the graft. The approach described in this article provides enhanced visualization, allowing better graft positioning, proper vascularization, and increased procedural stability.</p><p><strong>Methods: </strong>This case report details the interdental papilla reconstruction in a healthy 53-year-old female patient using a combination of techniques from the literature, adapted for optimized outcomes. The patient presented with a loss of gingival tissue between the lower left central incisor (24) and the lower right central incisor (25), resulting in a large black triangle. The reconstructive procedure involved papilla preservation via flap elevation, allowing wide visualization and precise graft placement. Composite resin was used to close the diastema after surgery.</p><p><strong>Results: </strong>The final outcome showed significant papillary gain, filling approximately 50% of the black triangle. The remaining space was covered with composite resin. After 2 years of follow-up, the procedure remained stable, with no signs of gingival recession.</p><p><strong>Conclusions: </strong>The combination of techniques used in this case is effective for papilla reconstruction in large interdental spaces, achieving a satisfactory outcome and resolving the patient's main concern. The method should be further replicated to refine its precision and viability, as various cases require tailored approaches, integrating both periodontics and restorative dentistry.</p><p><strong>Key findings: </strong>This case report demonstrates a combination of surgical and restorative techniques that effectively reconstructed the interdental papilla. A 50% papillary fill was achieved with stable results over two years. The proposed approach proves to be viable for the treatment of large black triangles using combined techniques.</p><p><strong>Key points: </strong>Enhanced visualization for precise graft placement, integrating surgical and restorative approaches, long-term stability.</p><p><strong>Plain language summary: </strong>This article discusses a case where the small tissue between the lower front teeth was lost and explores the benefits of a new type of surgical method for fixing it. A case report was done to look at different treatment options and compare the new method to existing methods in research. This surgical method has advantages, like better placement of the tissue graft. The case had good results, but more studies are needed to confirm how effective and reliable the technique is. The authors believe this could be a new and effective way to fix gaps between teeth.</p>","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of severe gingival recession using a double papilla connective tissue graft: A 2-year follow-up case study.","authors":"Yu-Chang Wu, Oscar Duran-Garnica, Hsun-Liang Chan, Dimitris N Tatakis","doi":"10.1002/cap.10368","DOIUrl":"https://doi.org/10.1002/cap.10368","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;This case study presents the treatment of a 7 mm deep and 5 mm wide RT1 gingival recession on the mandibular left canine in a 30-year-old systemically and periodontally healthy female, with the defect being associated with a self-injurious habit.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Following counseling, self-injurious habit cessation, and oral hygiene reinforcement, a double papilla flap (DPF) plus subepithelial connective tissue graft (SCTG) procedure (DPF+SCTG) was performed. After de-epithelialization of the gingival margin, horizontal and vertical incisions were made, and a partial-thickness DPF was elevated. The SCTG was placed at the cementoenamel junction level and covered by the DPF.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Nearly complete root coverage was achieved, with recession depth reduced to 1 mm and keratinized tissue width increased from 1 mm to 6 mm. Ultrasound imaging confirmed successful graft integration and thick gingiva. At 2-year follow-up, creeping attachment was observed after the patient discontinued the self-injurious habit, despite a prior recurrence that had caused additional trauma. The successful surgical outcome resulted in patient satisfaction, plaque control improvement, and prevention of further recession, benefiting the ongoing orthodontic treatment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;DPF+SCTG is an effective approach for treating an isolated deep and wide RT1 recession, providing long-term benefits, particularly when combined with behavior modification in patients with self-injurious habits.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key points: &lt;/strong&gt;Technique choice and patient behavior management: The combination of double papilla flap and subepithelial connective tissue graft effectively achieved significant root coverage and increased keratinized tissue width in a patient with self-injurious habit. However, patient behavior management was crucial in preventing recurrence. Long-term stability and creeping attachment: Despite a relapse due to the patient's habit, the thickened gingiva facilitated natural healing through creeping attachment, reinforcing the importance of both surgical intervention and behavioral modifications in maintaining long-term stability. Ultrasound for non-invasive monitoring: Ultrasound imaging confirmed successful graft integration and determined tissue thickness, highlighting its potential as a non-invasive periodontal healing monitoring tool.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Plain language summary: &lt;/strong&gt;Gum recession is a common condition where the gum tissue pulls away from the teeth, exposing the roots and making them more prone to damage. This report describes the treatment of a 30-year-old woman who had severe gum recession on her lower left canine tooth, caused by her long-term habit of scratching the gums with her fingernail. To restore the lost tissue and protect the tooth, a double papilla flap (a surgical technique that moves nearby tissue) along with a connective tissue graft (transplanted ","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk for peri-implant diseases and defects: Report of workgroup 1 of the joint AO/AAP consensus conference on prevention and management of peri-implant diseases.","authors":"Purnima S Kumar, Joseph Kan, Maria Elisa Galarraga-Vinueza, Guo-Hao Lin, Alberto Monje, Lorenzo Tavelli, Sandra Stuhr, Yung-Ting Hsu, Junying Li, Alexandra Tsigarida, Debora Dias, SukirthMurthy Ganesan, Shi Yin, Don Curtis","doi":"10.1002/cap.10367","DOIUrl":"https://doi.org/10.1002/cap.10367","url":null,"abstract":"<p><strong>Background: </strong>A consensus meeting on peri-implant diseases and treatment was initiated by the American Academy of Periodontology (AAP) and the Academy of Osseointegration (AO) with the goal of developing subject- and site-level risk profiles for peri-implant diseases and defects, and risk-informed treatment recommendations. This report summarizes the conclusions of Working Group 1.</p><p><strong>Methods: </strong>Working Group 1 evaluated the risk for peri-implant diseases and defects based on four commissioned systematic reviews, followed by an in-person workshop to discuss the reviews and the inferences.</p><p><strong>Results: </strong>Several factors emerged as risk markers for peri-implant mucositis, peri-implantitis, as well as for soft and hard tissue discrepancies and defects in the absence of disease.</p><p><strong>Conclusion: </strong>Patient- and site-level factors can increase the odds of developing peri-implant disease or defects in soft tissue and marginal bone surrounding clinically healthy implants. Risk-informed treatment recommendations were made by the panel of experts.</p><p><strong>Key points: </strong>This consensus estimates risk based on both patient and site-level factors. Consideration must be given to modifiable and non-modifiable risk factors, and treatment modified accordingly. There is a lack of primary research on several topics that were considered by the consensus panel, and several gaps in knowledge still continue to exist.</p>","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retro molar papilla pedunculated flap: A retrospective case series.","authors":"Marco Castiglioni","doi":"10.1002/cap.10366","DOIUrl":"https://doi.org/10.1002/cap.10366","url":null,"abstract":"<p><strong>Background: </strong>The primary purpose of this paper is to introduce a new flap design to improve keratinized tissue (KT) around implants in the posterior mandible, avoiding the need for harvesting tissue from the palate, which is associated with significant discomfort for patients.</p><p><strong>Methods: </strong>Eleven patients requiring implants in the molar regions with a KT width (KTW) < 2 mm at the buccal aspect were treated using this surgical technique. Outcomes, including the increase in KT width and postoperative discomfort, were measured at intervals of 1, 4, and 10 months.</p><p><strong>Results: </strong>An average increase of 4.2 mm in KT width was achieved. Postoperative pain was minimal, with most patients reporting low scores on the Visual Numerical Scale. No significant reduction in KT width was observed during follow-up.</p><p><strong>Conclusion: </strong>Within the limitations of the present case series, the data suggest that this flap is a promising and less invasive technique for treating KT deficiency around implants, eliminating the need for palate harvesting. Further long-term studies are needed to confirm the stability of the results.</p><p><strong>Plain language summary: </strong>This case series presents a new surgical method designed to improve the protective gum tissue (called keratinized gingiva) around dental implants in the back part of the lower jaw. This type of gum tissue is important because it helps keep implants stable and healthy over time. Traditionally, the best way to add this tissue is by taking a piece from the roof of the mouth, but that can be painful and lead to complications. In recent years, researchers have explored less invasive options, but most haven't matched the effectiveness of using the patient's own tissue. In this study, the new approach allowed the treatment of 11 patients who had too little gum tissue around their implants. The technique used the patient's own gum tissue but avoided taking it from the palate, making the procedure more comfortable. The results showed that this method was effective in increasing the amount of healthy gum tissue, offering a promising alternative that prioritizes both results and patient comfort.</p><p><strong>Key points: </strong>Effective strategies for increasing keratinized tissue in Mandibular posterior areas. Minimal postoperative discomfort; minimally invasive surgery Stability of peri-implant tissues.</p>","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clear orthodontic aligners in patients with a history of severe periodontitis: Two case reports with 12 months of follow-up.","authors":"Ana Carla Raphaelli Nahás, Mayara Paim Patel, Liliana Avila Maltagliati, Murilo Matias, Sandra Marques De Jesus, Renata Tavares, Renata Amad, Danilo Vinicius Aparecido De Paula Domingues, Katiane Silva Sousa, Edoardo Staderini, Israel Chilvarquer, Michel Eli Lipiec-Ximenez, Magda Feres, Belen Retamal-Valdes","doi":"10.1002/cap.10301","DOIUrl":"https://doi.org/10.1002/cap.10301","url":null,"abstract":"<p><strong>Background: </strong>The orthodontic treatment of patients with a history of severe periodontitis helps to improve periodontal health, functional occlusion, and esthetics. The use of aligners in patients with a history of severe periodontitis, with a single protocol of periodontal treatment, and the report of periodontal parameters throughout the orthodontic treatment has not yet been evidenced. Therefore, this manuscript aimed to describe the treatment with a clear orthodontic aligner system in two patients with reduced periodontium associated with a history of severe periodontitis.</p><p><strong>Methods and results: </strong>Two male participants (43-year-old and 62-year-old, respectively) were diagnosed with generalized, stage III, grade B periodontitis and treated with the same periodontal treatment protocol. After a 12-month follow-up of periodontal maintenance, the subjects were referred for tooth migration and Class II malocclusion orthodontic treatment. The subjects received orthodontic treatment with clear aligners. After starting orthodontic therapy, the patient received periodontal maintenance and clinical monitoring at 3, 6, 9, and 12 months. The periodontal parameters remained stable throughout the aligner treatment. At 12 months of orthodontic treatment, an improvement in angulations, inclinations, and dental positioning was observed, obtaining a stable occlusion, and reaching the proposed objectives for the treatment stage.</p><p><strong>Conclusions: </strong>A significant improvement in the occlusal relationship could be achieved with the clear orthodontic aligner system in adult patients with reduced periodontium by a history of severe periodontitis. Orthodontic therapy with clear aligners was shown to be safe in maintaining good periodontal health with the protocol of periodontal treatment used in the clinical cases presented.</p><p><strong>Plain language summary: </strong>This case presentation is a contemporary and innovative approach to orthodontic and periodontic treatment of patients with a history of severe periodontitis that in the recent past would not be referred to an interdisciplinary treatment because of the lengthy orthodontic treatment time and the difficulty of hygiene that fixed appliance brings, putting at risk the permanence of these teeth in the oral cavity even with adequate periodontal treatment. The keys to the success of this partnership intervention are a precise diagnosis and careful treatment planning of orthodontic treatment and a correct periodontal intervention to keep teeth and periodontium in good health. The primary limitation is without a doubt, the patient's collaboration both in the correct use of the aligners and in the adherence to periodontal treatment.</p>","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guided-modified coronally advanced flap: Novel digital approach to treat multiple gingival recessions. Workflow and case study.","authors":"Mauro Pedrine Santamaria, Ana Carolina Ferreira Bonafé, Amanda Rossato, Manuela Maria Viana Miguel, Andrews Porto da Costa, Ingrid Fernandes Mathias-Santamaria, Marcelo Pereira Nunes, Lucas Araújo Queiroz","doi":"10.1002/cap.10362","DOIUrl":"https://doi.org/10.1002/cap.10362","url":null,"abstract":"<p><strong>Background: </strong>Gingival recession (GR) poses esthetic and functional challenges for patients, particularly in cases of multiple adjacent defects. Traditional surgical approaches, such as the modified coronally advanced flap (MCAF) with connective tissue grafts (CTG), demand high levels of precision and skill, making outcomes reliant on clinician expertize. The integration of digital technologies, including cone-beam computed tomography (CBCT) and computer-aided design and manufacturing (CAD-CAM), offers a novel, standardized approach to enhance procedural accuracy and predictability.</p><p><strong>Methods: </strong>This case study describes the use of the guided-modified coronally advanced flap (g-MCAF) for the treatment of multiple GR defects. A patient whose main concern was the esthetic appearance of her teeth was treated. Using an intraoral scanner, CBCT data, and CAD-CAM software, surgical guides were designed and 3D printed using a dedicated resin, assuring precise adaptation to the patients' teeth. The guides delineated MCAF oblique incisions and free gingival graft dimensions tailored to fit into the area, facilitating flap design, and graft harvesting.</p><p><strong>Results: </strong>The guided MCAF (g-MCAF) procedure successfully achieved complete root coverage. At the 6-month follow-up, recession reduction was observed, measuring 2.22 mm for tooth #5, 2.59 mm for tooth #6, and 2.26 mm for tooth #7. Gingival thickness also increased, reaching 1.23, 1.16, and 1.45 mm, respectively. Additionally, the patient reported improved esthetics and reduced hypersensitivity.</p><p><strong>Conclusion: </strong>The g-MCAF technique may have the potential to serve as a reliable aid to execute MCAF in the management of multiple GR defects.</p><p><strong>Key points: </strong>A guided surgical approach (g-MCAF) using digital technologies allows for precise flap design and graft harvesting, which may help control variability and minimize errors during root coverage procedures. The integration of CBCT, intraoral scanning, and CAD-CAM technologies supports preoperative planning, potentially contributing to safer and more predictable outcomes, particularly in cases requiring connective tissue grafts. This innovative approach may assist in simplifying complex surgical techniques, improving clinician confidence, and serving as both a clinical and an educational tool for periodontal plastic surgery.</p>","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Periosteal-guided bone regeneration on severely damaged sockets with simultaneous implant placement: The cortical shield cross-sectional study.","authors":"Fernando Verdugo, Antonio D'Addona, Theresia Laksmana, Agurne Uribarri","doi":"10.1002/cap.10364","DOIUrl":"https://doi.org/10.1002/cap.10364","url":null,"abstract":"<p><strong>Background: </strong>Bone regeneration and simultaneous implant placement in severely damaged sockets are challenging and may require multiple grafting. Periosteal-guided bone regeneration enhances osteogenesis and wound healing shortening immediate and delay implant protocols. Clinical outcomes of a group of individuals that entered a longitudinal clinical trial from 2019 to 2021 are reported describing a novel surgical approach of simultaneous reconstruction and implant placement.</p><p><strong>Methods and results: </strong>Eight individuals requiring an implant and presenting severe facial bone loss were followed for 2-4 years (37-month average) after the completion of a 12-month longitudinal clinical trial NCT04827693. Socket reconstruction and simultaneous implant placement were performed by encasing the implant in a customized shield of autogenous cortical bone. Peri-implant tissues and pink esthetics data were assessed following established success criteria. Mean healing time, before second stage surgery, after implant placement and reconstruction, was 12.5 ± 0.9 weeks (range: 12-14 weeks). Success rates were 100% at 2-4 years. Cone beam computed tomography (CBCT) data showed stable facial cortical bone >2.1 mm in thickness. Pink esthetic scores (PESs) were above optimal (9.5 ± 0.5, range: 9-10), with no significant difference between delayed and immediate individuals (p > 0.05). Facial implant transparency at follow-up was absent and all had a band of keratinized tissue >2 mm with healthy probing depths ranging from 3 to 4 mm.</p><p><strong>Conclusion: </strong>Facial bone regeneration and simultaneous implant placement are feasible through periosteal-guided bone regeneration after a short healing period in severely damaged sockets following immediate or delay protocols. The assisted regenerated intrasocket bone provides high pink esthetics and functional implant stability.</p><p><strong>Key points: </strong>Regeneration and simultaneous implant placement of severely damaged sockets is feasible. Periosteal-guide bone regeneration can shorten healing times. Teeth with fragile alveolar foundation can be successfully reconstructed achieving high pink esthetics.</p><p><strong>Plain language summary: </strong>Simultaneous dental implant placement and bone regeneration are possible in severely damaged sockets that require reconstruction achieving, after a short healing period, highly esthetic outcomes.</p>","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laterally positioned flap with connective tissue graft to treat deep isolated gingival recessions in the mandibular anterior region: A retrospective case series with 10-year follow-up.","authors":"Lucrezia Parma-Benfenati, Stefano Parma-Benfenati","doi":"10.1002/cap.10358","DOIUrl":"https://doi.org/10.1002/cap.10358","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;To evaluate the efficacy and long-term clinical outcomes of the one-stage procedure for covering isolated deep gingival recessions (GRs) in the mandibular anterior region employing a laterally positioned flap (LPF) with a connective tissue graft (CTG), with a retrospective case series.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Nine patients presenting 11 isolated mid-facial recessions, where no loss of attachment level or the interproximal loss is equal to or less than the buccal one, received a LPF with CTG. The study's primary outcome was the percentage of mean gingival recession coverage (mGRC) and its stability over time. Secondary endpoints included the frequency of complete gingival recession coverage (CGRC), changes in keratinized tissue width (KTW) over time, and final root coverage aesthetic score (RES).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The mean of CGRC was 0.7, 0.4, and 0.5 mm for each time point with a mean up to 90% after the first year and up to 95% for 5- and 10-year follow-ups expressed in percentage, reporting an increase in KTW as well. At 1-, 5-, and 10-year follow-ups, the mean of the RESs was, respectively, 8, 7.04, and 7.09.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The present results suggest that the LPF + CTG is a valuable approach for treating deep isolated mandibular single recession type 1 (RT1) and RT2 GRs. It results in a favorable mean of CGRC, stable clinical outcomes over time, and an increase in KTW, with undisputed patient benefits and great clinician satisfaction.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key points: &lt;/strong&gt;This study highlights the effectiveness of a one-stage procedure using a laterally positioned flap (LPF) and connective tissue graft (CTG) for treating isolated deep gingival recessions (GR) in the mandibular anterior region. The primary outcome measured was the mean gingival recession coverage (mGRC) over time, while secondary metrics included complete gingival recession coverage (CGRC), keratinized tissue width (KTW), and root coverage aesthetic scores (RES). The mean CGRC was 90% after 1 year and 95% at 5 and 10 years; the mean RES scores were 8, 7.04, and 7.09 at the 1-, 5-, and 10-year follow-ups, respectively; KTW also increased significantly. These results confirm that the LPF + CTG technique is not only effective for treating recession type 1 (RT1) and RT2 GRs but also offers substantial benefits for patients and high satisfaction for clinicians, making it a recommended approach in practice.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Plain language summary: &lt;/strong&gt;This case series aims to describe the effectiveness of the laterally positioned flap as a reliable and predictable technique for root coverage in cases of single isolated mandibular recession. The paper evaluates the mean rates of complete root coverage and increases in keratinized tissue following the surgical procedure, assessed at 1, 5, and 10 years postoperation. The results demonstrate good aesthetic outcomes and favorable clinical stability of the tissues ","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Periodontal reconstructive surgery with improved papilla architecture: Case report with 24 months of follow-up.","authors":"Michele Perelli, Rodrigo Neiva, Roberto Abundo, David Barack","doi":"10.1002/cap.10354","DOIUrl":"https://doi.org/10.1002/cap.10354","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Periodontal defect reconstruction often relies on bone or bone substitutes to fill defects, membranes to exclude tissues unsupportive of new bone and attachment, and biologics to stimulate cells for healing and tissue formation. The scaffold we used is a nonparticulate osteoconductive bone substitute for repairing defects without migration of particles and maintaining volume above the walls and confines of the periodontal treatment site. This may provide a more predictable option for rebuilding lost supporting bone, especially in less contained defects.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A case of periodontitis stage III grade A at tooth no. 5 treated with intentional defect overfill to sustain interdental papilla with filling of the defect. Established guided tissue regeneration techniques were used.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;After 15 days, complete soft tissue closure at the defect site and root coverage at tooth 6 due to coronal advancement of the flap were observed. After 1 year, the papilla between teeth 6 and 5 filled the interproximal space, recession at 6 and 5 was 0 mm, and clinical attachment level gain at 5 was 4 mm. Soft-tissue maturation continued over 2 years, showing increasing thickness and healthy aspect. Over 24 months, increasingly defined bone-like imagery of the infrabony defect was obtained on X-ray without probing.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Using a cross-linked, completely resorbable collagen scaffold covered with a membrane based on the same engineering promoted tissue growth above the walls of the defect. This was effective in bone regeneration of an intrabony defect.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key points: &lt;/strong&gt;Why is this case new information? This is a case report describing the use of a completely resorbable ossifying collagen sponge with intentional overfill of the periodontal defect. This surgical technique allowed the clinician to improve the reduced interdental papilla architecture together with filling of the defect. This outcome represents a difficult and unpredictable goal for traditional periodontal reconstructive therapy. What are the keys to successful management of this case? Proper diagnosis and treatment planning Adequate and minimally invasive nonsurgical preoperative preparation of the soft tissues Graft trimming and proper adaptation Soft tissue management with mucogingival approach (split thickness papilla incision-flap elevation-sutures) What are the primary limitations to success in this case? Inadequate preoperative nonsurgical therapy Poor handling of soft tissue Inadequate graft shaping Strict adherence to pre- and postoperative oral hygiene and maintenance PLAIN LANGUAGE SUMMARY: Bone or bone substitutes can be used to rebuild lost supporting bone in dental repairs. A female patient at risk of tooth loss because of gum infection and with a gap between two of her teeth was surgically treated with an ossifying collagen sponge (OSSIX Bone, Dentsply Sirona/Regenera","PeriodicalId":55950,"journal":{"name":"Clinical Advances in Periodontics","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144046525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}